The MS Aquarius spots this dinghy in distress with 112 people on board, just as it begins to rain. A small boat, or RHIB, sent from the Aquarius, attempts to calm the people on board until help arrives. The dinghy had been at sea for 14 hours, departing under cover of darkness to avoid the Libyan Coast Guard.

Kevin McElvaney joins SOS Méditerranée as they pull hundreds of refugees out of the sea along the treacherous Mediterranean route to Europe.

In the past year, the journey of refugees fleeing conflict in West Africa and parts of the Middle East has become more perilous. More than 5,000 refugees have died attempting to cross the Mediterranean.

After recent crackdowns in Turkey, the well-trodden Aegean route from Turkey to Greece is no longer a viable option for many refugees. Instead, Libyan ports, dominated by smuggling operations, are now the main hub. But on this alternate route across the Mediterranean, the risk of dying is 10 times higher. Refugees, along with trafficked individuals captured by smugglers and forced to make the crossing, board small dinghies unfit for the much longer route across the open ocean.

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As the waves climb higher and rain grows stronger, Nicola Stalla, deputy rescue coordinator, takes control of the rescue operation. Women and children, who were previously hidden on the bottom of the boat, are rescued. Other refugees clamber to be the next ones to disembark their doomed dinghy.

Now, hope for embattled refugees comes in the form of a 40-year-old former fishery protection vessel, the MS Aquarius. Jointly operated by SOS Méditerranée and Médecins Sans Frontieres (Doctors Without Borders), the ship and its crew search for refugees in the Mediterranean who otherwise would have very little chance of surviving.

The ship launches at least one mission a week, rescuing up to 600 people at a time. German photographer Kevin McElvaney is accompanying the Aquarius on a three-week expedition; at the time of publication, he was was on his way to a third rescue mission.

McElvaney was inspired to join the ship after seeing the results of a project he calls #RefugeeCameras. While documenting the Aegean refugee route, he distributed disposable cameras to refugees to photograph their journey themselves. He exhibits those photographs and sends the proceeds to SOS Méditerranée, a nonprofit operation run partly by volunteers, which costs about 11,000 Euros ($11,580) per day to operate.

Each mission presented its own challenges. The first took place at night, in a stormy sea. In the second, the Aquarius rescued 607 refugees from a small wooden boat and brought them in one group at a time. Complications with a British Navy vessel participating in the rescue resulted in an attempt that took a total of 14 hours.

McElvaney scrambled to capture the fluid scene—and adapt to conditions that are less than ideal for photography.

“In the end, you can't prepare yourself,” he says.“You need the right experience, intuition, and luck.”

When a boat in distress is spotted or radioed in, the Italian Maritime Rescue Coordination Centre puts out a call to boats in the area to attend to the vessel. Sometimes, the refugees even call the Maritime Rescue Coordination Center in Italy themselves once they’re out of Libyan waters.

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Rescue workers in a small RHIB provide life jackets to refugees in advance of their rescue, should any of them decide to jump or fall off the boat before they can be rescued. The larger ship stays out of sight to prevent refugees from jumping and attempting to swim toward it.

Photograph by Kevin McElvaney

When the Aquarius crew spots a boat of refugees, it first sends a small rigid-hulled inflatable boat, or RHIB, with a team (including a translator) from Doctors Without Borders to find out if any refugees are in need of medical attention and to hand out life vests.

“The main ship stays out of the way so refugees don’t try to jump on the boat,” McElvaney says. The life vests protect them if they decide to jump off anyway.

Once the situation has been assessed, a slightly larger rubber boat equipped for rescues shepherds refugees onto the larger vessel in groups of 18 to 20 at a time, starting with women and children.

Even though the mission is humanitarian, the response to McElvaney’s photographs has been mixed.

“I understand that some people in Europe and elsewhere are afraid,” he says of the negative commenters. “But I feel sad that they can’t understand the bigger picture of this situation.”

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The MS Aquarius navigates southbound towards the search-and-rescue (SAR) zone off Libya, where it will be the only civic rescue ship operating during the winter months. While en route, the ship receives the first SOS call and begins to travel to the estimated location as quickly as possible.

Photograph by Kevin McElvaney

Coming face-to-face with migrants fleeing desperate circumstances, he says, has opened his own eyes to their plight.

“I began to understand more deeply what it means to be a refugee,” he says. “So much has happened to them, and many made the decision—to be either dead or to reach Europe. There was no way back.”

The main problem with the route, according to McElvaney, lies with Libya.

“Libyan ports are run by militias of smugglers,” he says. “The lives of people aren’t worth very much to them.”

A refugee told McElvaney a story of how his smuggler shot and killed one man in his group. The refugee decided to get on the boat lest he suffer the same fate.

McElvaney was not only moved by their terrifying tales, but also by their gestures of gratitude.

“It’s always tiny moments in between that struck me most,” he says. “After my first rescue, I was on watch, and I met a refugee from the Ivory Coast on the upper deck. We looked to the south, towards Libya, and he said, ‘Libya … no good … thank you! Merci!’ I didn’t need to hear more; I felt his deep compulsion to say ‘Thank you.’”

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A vehicle for exodus, the Aquarius also provides many refugees with the opportunity to tell their stories and face the past for the first time since leaving home. Cultural mediators help the refugees get in touch with specialized organizations in Italy.